APPLICATION

APPLICATION
for participation in the international competitions
Mountaineering World Championship

Class of competitions – rock.

Date – 29th September – 8th October, 2013, Ukraine, Crimea.

Country _________________________________________

Team __________________________________________________________
                                     
(Name of the Organization, sending the team)

Coach-representative ________________________________, 19___ year of birth.                                                                                  (Full Name, Year of Birth)

Referee  ____________________________, _____category, 19___ year of birth.                                                                                     (Full Name; Referee Category, Year of Birth)

Lineup:

Full Name

Nationality

Sex
m/f

Year of Birth

Grade or Maximal Category of Mountaineering

Notes

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3

 

 

 

 

 

 

4

 

 

 

 

 

 

5

 

 

 

 

 

 

6

 

 

 

 

 

 

                Acquainted with Regulations of Mountaineering World Championship 2013 (rock class).

 

 

Head
of the National Federation/ Club

___________________/_____________________/                                                                                          (Signature, Full Name)

locus sigilli                           “____”____________2013